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Senior moment or something more serious?

Dr. Tiffany Chow, a senior scientist with Baycrest Health Sciences’ world-renowned Rotman Research Institute in Toronto, knows as much about dementia and Alzheimer’s as anyone can.

But even she was surprised to learn that her seemingly healthy grandmother’s sudden death was due to Alzheimer’s.

Since the disease has a hereditary component, Chow, 46, now finds herself researching a condition she’s more likely than most to get later in life. She writes about this experience and offers advice to people with the disease or interested in preventing it in her book, The Memory Clinic.

When my grandma lost consciousness, I was there the next day. I went down to look at her scan with her medical team. It was obvious she’d had a hemorrhage, but wasn’t until much later that I pieced it together. It was years after her death and even years after working in this field.

If you’re no longer able to do something you have been good at for most of your life, that’s a red flag for me.

A: I’m concerned enough that I made sure to pick a partner who I thought would be able to take care of me as I get older. I don’t think anyone is guaranteed not to have cognitive impairment and since that’s what I do, I need to be sure that my husband understands that being loved, happy and healthy are my goals for each day, whether or not I’m on top of my game. And I think I am doing a better job of asking for help when I need it. I am practicing ahead of time.

Q: What worries most people who come to your clinic for the first time?

A: There are two major reasons why people come in. One is because their family is bugging them to come in. The other reason is that people value the ability to multitask, do things quickly or remember a lot of facts, and it’s slipping as they age. Quite a bit of that is normal. But it’s not so clear from the newspapers or a television show when you are out of a normal range.

Q: What is the line? We all joke about “senior moments,” but what’s the sign that there is something to real to worry about?

A: If you’re no longer able to do something you have been good at for most of your life, that’s a red flag for me. So you forget where you put your car keys once every three months, or you can’t remember people’s names as well as you used to 20 years ago, I’m not so worried about that. What I am worried about is someone who regularly throws dinner parties for 10 at her home and now can’t seem to organize that anymore – dinner is getting burned or she thought she sent the invitations out but didn’t. Things that are “hardwired” that are falling apart on you probably call for an investigation.

Q: What do you to do protect your brain, and how can others prevent Alzheimer’s?

A: I’ve always been a regular exerciser, in addition to trying to sleep well at night. The other thing that I’m working on is thinking more about what I’m eating. I’m a big meat eater and there’s more and more evidence that says we should back away from that.
I think the one thing that is maybe easier for people to do than change their diet is develop a social network. You should remain engaged in your community – your circle of friends, your neighbourhood, your church, or a charitable organization. There are so many indicators that this type of interaction really stimulates the brain and has a protective effect against cognitive impairments later in life.

You should remain engaged in your community – your circle of friends, your neighbourhood, your church, or a charitable organization.

Q: Do brain games work?

A: One of the important things to keep in mind is that because so many people will be affected by dementia or Alzheimer’s disease, there’s big business behind it. You do get better at playing the game, but that doesn’t necessarily mean that your memory would be improved. There are other activities that seem to bear more fruit – like reading.

Q: Do any moments with your patients stand out?

A: There’s a woman who is in her 50s who has early onset Alzheimer’s disease. She used to provide services for children with autism. At this point she can’t drive a car, she can’t be responsible for children and yet she found art. Every time she comes into the office she has a sketchbook full of drawings that she’s done; beautiful abstractions of nature. She has a really calm, serene smile on her face when she’s been working on these. It’s nice for her husband, because he sees that she is happy.

Q: What’s the advantage of having a diagnosis?

A: One of the reason I would encourage people to pursue a diagnosis is to be able to plan for the next five years. If I knew that I was not going to be as independent four or five years from now, I would make sure to get my health in order. It’s not quite the same as being diagnosed with a terminal illness, but if you’re concerned about how you will be cared for, this is the time to get it together. And no matter what, everyone should have a power of attorney. These things are much better to handle way ahead of the game.

Q: What about drugs? Do they help?

A: About 20 or 25 per cent of people with Alzheimer’s disease will respond to already available medications. There are many people out there worrying that they have been told they may have mild cognitive impairment, which leads to Alzheimer’s disease in most people. Unfortunately, there is no information to suggest that those people should take drugs for Alzheimer’s disease.

Q: How can people compensate for brain changes?

A: One of the most important things is to reach out to other people for help. We pride our independence in North America so much that a lot of people, especially if you’ve had a lifetime of high achievements, have a hard time asking for help. But it’s important to get used to doing that, accepting it graciously and helping others.

You need a supportive network, not just a social network. It’s not that you are hanging out and talking — you’re being involved in the lives of others. You need someone who can hear about your fears, give reality checks and also help out. If you are starting to have cognitive impairment, you have to let people know you are having trouble, or they cannot help you.

A: Pace yourself. This is a disease that goes on for a long time, upwards of 10 years. When caregivers first hear of the diagnosis they feel very responsible for many aspects, really devoting themselves to try reverse what the person is going through. That happens with every single one of our caregivers. At a certain point they realize

“This is really happening and I can’t make it go away and it’s not my fault that I can’t make it go away. I need to make the person get through each day and feel good about whatever is going on.” That is actually not as hard as trying to cure the disease. When the person is safe, not in pain, where they aren’t being criticized or coached, just accepted as they are that day, then you are done.